Consolidated Insurance Services

Cigna Access

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2009 MA and MAPD plans are below.
 
Plans are effective January 1, 2009.

 
Covered Services Plan One Plan Two Plan Three Plan Four
Monthly premium $40 $65 $95 $140
Maximum Out-of-Pocket limit $3,000 $3,500 $2,500 $2,000
Prescription Drugs



- Deductible n/a $0 n/a 0
- Tier 1 n/a $7 copay* n/a $7 copay*
- Tier 2 n/a $33 copay n/a $33 copay
- Tier 3 n/a $80 copay n/a $80 copay
- Tier 4 n/a 33% n/a 33%
Office visits



PCP $10 $10 $10 $5
Specialist $35 $40 $20 $10
X-Rays 15% of costs 15% of costs %15 of costs 10% of costs
Laboratory services 15% of costs 15% of costs %15 of costs 10% of costs
Inpatient Hospital $175 copayment $230 copayment $50 copayment $30 copyment

Days 1-6 Days 1-6 Days 1-6 Days 1-6
Outpatient Surgery $35 $40 $20 $10
Emergency Room $50 50 $50 $50
Urgent Care $10 $10 $10 $5
Ambulance Services $150 $150 $100 $100
Preventive Care



- Annual Physical Exam $10 $10 $10 $5
- Immunizations $0 $0 $0 $0
- GYN exams $0 $0 $0 $0
- Screening Mammograms $0 $0 $0 $0
- Bone Mass Measurements $0 $0 $0 $0
- Colorectal Screening Exams $0 $0 $0 $0
- Prostate Screening Exams $0 $0 $0 $0
Vision n/a n/a $20 copay/$75 limit 2yrs $10 copay/ $100 limit 2yrs
Hearing n/a n/a $20 exam $10 exam
Dental** 25% preventive services 25% preventive services 25% preventive services 25% preventive services
* Mail order $17.50 for 90day supply



** Allows for up to 2 oral exams, 2 cleanings, and 1 X-ray per year.  Amounts paid on preventive dental benefits do NOT apply to your out-of-pocket maximum.

Health/Wellness:
Nursing hotline
Newsletter
 
Diabetes you pay
15% of supplies on plans
One through Three.
10% on plan Four.

For more information or to enroll into this plan please call us at (503) 936-8905.

Kyle Rogers * 1075 NW 123rd Ave #2 * Portland, OR * 97229

Your local independent agents serving Oregon & Washington